NHS Track & Trace
Welcome to POPSI'S! Thank you for visiting us today, we hope you have a fantastic meal!
In order to comply with UK law from 14.09.2020 all customers dining out at a restaurant are required to provide their full names and contact numbers. This data will be stored for a minimum of 21 days in the cloud, and will be provided to the NHS should any customer test positive for covid-19. We will not be using the data on this form for marketing purposes. Full details can be found at
Date of Visit
Time of Visit (24hr Format Please)
Guest 1: Full Name & Number
Guest 2: Full Name & Number
Guest 3: Full Name & Number
Guest 4: Full Name & Number
Guest 5: Full Name & Number
I have provided the full names and numbers for my party today and to the best of my knowledge the information is correct. I also understand that this information will be provided to the NHS should they request it.
I agree to the above and I agree to POPSI'S storing my data for the purpose of NHS Track & Trace
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service